Anesthesia with nontracheal intubation in thoracic surgery

To study one-lung respiration during VATS wedge resection of bullae and pulmonary nodules with nontracheal intubation, and to explore the changes of vital signs when patients return to two-lung ventilation. Twenty-two patients with normal cardiopulmonary function and absence of contraindications to...

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Veröffentlicht in:Journal of thoracic disease 2012-04, Vol.4 (2), p.126-130
Hauptverfasser: Dong, Qinglong, Liang, Lixia, Li, Yingfen, Liu, Jun, Yin, Weiqiang, Chen, Hanzhang, Xu, Xin, Shao, Wenlong, He, Jianxing
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container_end_page 130
container_issue 2
container_start_page 126
container_title Journal of thoracic disease
container_volume 4
creator Dong, Qinglong
Liang, Lixia
Li, Yingfen
Liu, Jun
Yin, Weiqiang
Chen, Hanzhang
Xu, Xin
Shao, Wenlong
He, Jianxing
description To study one-lung respiration during VATS wedge resection of bullae and pulmonary nodules with nontracheal intubation, and to explore the changes of vital signs when patients return to two-lung ventilation. Twenty-two patients with normal cardiopulmonary function and absence of contraindications to epidural anesthesia were included in this study. VATS wedge resection of bullae or pulmonary nodules was performed. 0.5% Ropivacain was administrated for epidural anesthesia (T8-9), and 2 mL of 2% lidocaine was used for local anesthetic block of the intrathoracic vagus nerves. The BIS value was maintained between 50 and 70 by target-controlled infusion of propofol and remifentanil. Electrocardiogram (ECG), heart rate (HR), blood pressure (Bp), pulse oxygen saturation (SpO(2)), respiratory rate (RR), bispectral index (BIS) and urine volume were monitored. None patients were converted to endotracheal intubation during anesthesia. MAP and SpO(2) after wound disclosure were stable (P>0.05), level of CVP significantly elevated, HR and RR increased (P
doi_str_mv 10.3978/j.issn.2072-1439.2012.03.10
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Twenty-two patients with normal cardiopulmonary function and absence of contraindications to epidural anesthesia were included in this study. VATS wedge resection of bullae or pulmonary nodules was performed. 0.5% Ropivacain was administrated for epidural anesthesia (T8-9), and 2 mL of 2% lidocaine was used for local anesthetic block of the intrathoracic vagus nerves. The BIS value was maintained between 50 and 70 by target-controlled infusion of propofol and remifentanil. Electrocardiogram (ECG), heart rate (HR), blood pressure (Bp), pulse oxygen saturation (SpO(2)), respiratory rate (RR), bispectral index (BIS) and urine volume were monitored. None patients were converted to endotracheal intubation during anesthesia. MAP and SpO(2) after wound disclosure were stable (P&gt;0.05), level of CVP significantly elevated, HR and RR increased (P&lt;0.05), PaCO(2) increased gradually while PaO(2) remained stable. Fifteen minutes after wound closure, MAP, RR and SpO(2) returned to their pre-anesthesia levels, PH value gradually recovered, PaCO(2) tended to decrease and returned to normal one hour after wound closure. Physical agitation occurred in one case due to inadequate epidural anesthesia during skin incision. Cough before intrathoracic vagal blockade was noted in two cases (9.1%) because of lobe traction. Nontracheal intubation is feasible in VATS wedge resection of bullae and pulmonary nodules. 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title Anesthesia with nontracheal intubation in thoracic surgery
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